Replacement of Missing Anterior Teeth in a Patient with Chronic Mouth Breathing and Tongue Thrusting

The loss of anterior teeth has serious functional, esthetic disabilities, in addition to compromising the patients' quality of life. Various etiologies can be attributed to the anterior tooth loss, including trauma, caries, and periodontal diseases. The chronic mouth breathing due to nasal adenoids is known to enhance the gingival and periodontal diseases. The dental literature proves the association of nasal breathing, tongue thrusting, and anterior open bite. Arch shape and tooth position are primarily determined by the equilibrium of the forces from tongue and perioral musculature. Increased force from tongue musculature in the tongue thrusting patient leads to flaring of anterior teeth, making them susceptible for periodontal and traumatic tooth loss. Replacement of the anterior teeth in this patient will also help in restoration of anterior guidance, which is critical for the health of temporomandibular joint, posterior teeth, and musculature.

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Noninvasive and Multidisciplinary Approach to the Functional and Esthetic Rehabilitation of Amelogenesis Imperfecta: A Pediatric Case Report

Case Reports in Dentistry ◽

10.1155/2014/127175 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 5

Author(s):

Juliana Feltrin de Souza ◽

Camila Maria Bullio Fragelli ◽

Marco Aurélio Benini Paschoal ◽

Edson Alves Campos ◽

Leonardo Fernandes Cunha ◽

...

Keyword(s):

Case Report ◽

Composite Resin ◽

Preventive Treatment ◽

Open Bite ◽

Amelogenesis Imperfecta ◽

Mixed Dentition ◽

Anterior Open Bite ◽

Posterior Teeth ◽

Anterior Teeth

Case Report. An 8-year-old girl with amelogenesis imperfecta (AI) reported unsatisfactory aesthetics, difficulty in mastication, and dental hypersensitivity. The intraoral examination observed mixed dentition, malocclusion in anteroposterior relationships, anterior open bite, and dental asymmetry. A hypoplastic form of AI was diagnosed in the permanent dentition. A multidisciplinary planning was performed and divided into preventive, orthopedic, and rehabilitation stages. Initially, preventive treatment was implemented, with fluoride varnish applications, in order to protect the fragile enamel and reduce the dental sensitivity. In the second stage, the patient received an interceptive orthopedic treatment to improve cross-relationship of the arches during six months. Finally, the rehabilitation treatment was executed to establish the vertical dimension. In the posterior teeth, indirect composite resin crowns were performed with minimally invasive dental preparation. Direct composite resin restorations were used to improve the appearance of anterior teeth.Follow-Up. The follow-up was carried out after 3, 6, 12, and 18 months. After 18 months of follow-up, The restoration of integrity, oral hygiene, and patient satisfaction were observed .Conclusion. Successful reduction of the dental hypersensitivity and improvement of the aesthetic and functional aspects as well as quality of life were observed.

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Multiloop edgewise archwire treatment for a patient with a severe anterior open bite and amelogenesis imperfecta

The Angle Orthodontist ◽

10.2319/032221-228.1 ◽

2021 ◽

Author(s):

Ahmed I. Masoud ◽

T. Peter Tsay

Keyword(s):

Open Bite ◽

Amelogenesis Imperfecta ◽

Radiographic Examination ◽

Orthodontic Appliances ◽

Plane Angle ◽

Anterior Open Bite ◽

Posterior Teeth ◽

Anterior Teeth ◽

Mandibular Plane ◽

Mandibular Plane Angle

ABSTRACT Amelogenesis imperfecta is a rare hereditary disorder that affects dental enamel and is often associated with an anterior open bite. Orthodontic treatment of a 16-year-old female patient with hypocalcified amelogenesis imperfecta and a 9-mm anterior open bite was presented. Radiographic examination revealed a steep mandibular plane angle, an increased lower face height, a Class II skeletal pattern, and a convex profile. Additionally, the patient had stainless steel crowns on all upper and lower posterior teeth and composite veneers on the upper anterior teeth. The patient was treated nonsurgically using a multiloop edgewise archwire (MEAW). MEAW mechanics allowed for successful correction of the anterior open bite, with significant reduction in the mandibular plane angle and improvement in the patient's profile. No fixed retainers were used, results remained stable 78 months after removal of orthodontic appliances. MEAW mechanics should be considered for patients with large anterior open bites, although this technique requires excellent patient compliance.

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Comprehensive approach to simultaneous molar intrusion and canine retraction in the treatment of Class II anterior open bite using miniscrew anchorage

Dental Press Journal of Orthodontics ◽

10.1590/2177-6709.25.3.30.e1-12.onl ◽

2020 ◽

Vol 25 (3) ◽

Author(s):

Kaori Shirasaki ◽

Yoshihito Ishihara ◽

Hiroki Komori ◽

Takashi Yamashiro ◽

Hiroshi Kamioka

Keyword(s):

Treatment Duration ◽

Class Ii ◽

Open Bite ◽

Prolonged Treatment ◽

Anterior Open Bite ◽

Posterior Teeth ◽

Canine Retraction ◽

Maxillary Molars ◽

Anterior Teeth ◽

Molar Intrusion

ABSTRACT Introduction: Anterior open bite is one of the most difficult malocclusions to correct in orthodontic treatment. Molar intrusion using miniscrew anchorage has been developed as a new strategy for open bite correction; however, this procedure still has an important concern about prolonged treatment duration in the patient with anteroposterior discrepancy due to the separate step-by-step movement of anterior and posterior teeth. Objective: This article illustrates a comprehensive orthodontic approach for dentoalveolar open bite correction of an adult patient, by using miniscrew. Case report: A woman 19 years and 5 months of age had chief complaints of difficulty chewing with the anterior teeth and maxillary incisor protrusion. An open bite of -2.0 mm caused by slight elongation of the maxillary molars was found. The patient was diagnosed with Angle Class II malocclusion with anterior open bite due to the vertical elongation of maxillary molars. After extraction of the maxillary first premolars, concurrent movements of molar intrusion and canine retraction were initiated with the combined use of sectional archwires, elastic chains and miniscrews. Results: At 4 months after the procedure, positive overbite was achieved subsequent to the intrusion of maxillary molars by 1.5 mm and without undesirable side effects. Class I canine relation was also achieved at the same time. The total active treatment period was 21 months. The resultant occlusion and satisfactory facial profile were maintained after 54 months of retention. Conclusion: The presented treatment shows the potential to shorten the treatment duration and to contribute to the long-term stability for open bite correction.

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Negligible tooth resorptions after anterior open bite treatment using skeletal anchorage with miniplates

Dental Press Journal of Orthodontics ◽

10.1590/2177-6709.25.4.016-022.oin ◽

2020 ◽

Vol 25 (4) ◽

pp. 16-22

Author(s):

Genivaldo dos Santos ◽

Alberto Consolaro ◽

Fernanda Meloti ◽

Mauricio de Almeida Cardoso ◽

Ertty Silva ◽

...

Keyword(s):

Root Resorption ◽

Open Bite ◽

Dental Arch ◽

Anterior Open Bite ◽

Homogeneous Sample ◽

Posterior Teeth ◽

Anterior Teeth ◽

Before And After ◽

Applied Forces ◽

External Apical Root Resorption

ABSTRACT Introduction: When miniplates are used as anchoring for orthodontic mechanics for anterior open bite correction by retraction of anterior teeth and posterior teeth intrusion and retraction, orthodontically induced inflammatory external apical root resorption is clinically negligible. Methods: A homogeneous sample of 32 patients was used, and the roots of the teeth were compared on CT scans performed before and after orthodontic treatment. Results: The observed root resorption was minimal, and this can be explained by the uniform distribution of forces in several teeth, simultaneously, in the set of the dental arch and in the bone that supports the teeth. Conclusion: The most important thing to prevent root resorption in orthodontic practice, besides being concerned with the intensity of the applied forces, is to be careful with its distribution along the roots of each tooth, in the dental arch and in the bone that supports the teeth.

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Correction of open bite with temporary anchorage device-supported intrusion

APOS Trends in Orthodontics ◽

10.25259/apos_101_2019 ◽

2019 ◽

Vol 9 ◽

pp. 246-251

Author(s):

Joy Chang ◽

Shivam Mehta ◽

Po-Jung Chen ◽

Madhur Upadhyay ◽

Sumit Yadav

Keyword(s):

Treatment Approach ◽

Transverse Dimension ◽

Open Bite ◽

Anterior Open Bite ◽

Posterior Teeth ◽

Anterior Teeth ◽

Molar Intrusion ◽

Mandibular Plane ◽

Temporary Anchorage Device ◽

Transpalatal Arch

This case report describes the use of temporary anchorage device (TAD)-supported molar intrusion to correct anterior open bite and achieve overjet correction. A 13-year-old female presented with a Class II skeletal profile, with increased overjet and anterior open bite. She was treated with a combination of intrusion of the posterior teeth and extrusion of anterior teeth. The intrusion of maxillary posterior teeth was done with a palatal TAD and a transpalatal arch on the upper first molars to control the transverse dimension. The patient’s mandibular plane angle was maintained with this treatment approach.

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Effects of mouth breathing on facial skeletal development and malocclusion in children: A systematic review and meta-analysis.

10.21203/rs.3.rs-28100/v1 ◽

2020 ◽

Author(s):

Ziyi Zhao ◽

Leilei Zheng ◽

Xiaoya Huang ◽

Caiyu Li ◽

Jing Liu ◽

...

Keyword(s):

Systematic Review ◽

Skeletal Development ◽

Meta Analysis ◽

Mouth Breathing ◽

Occlusal Plane ◽

Cochrane Library ◽

Nasal Breathing ◽

Anterior Teeth ◽

Newcastle Ottawa Scale ◽

The Impact

Abstract BACKGROUND: Mouth breathing is closely related to the facial skeletal development and malocclusion. The purpose of this systematic review and meta-analysis was to assess the effect of mouth breathing on facial skeletal development and malocclusion in children. METHODS: An electronic search in PubMed, the Cochrane Library, Medline, Web of Science, EMBASE and Sigle through February 23rd, 2020, was conducted. Methodological quality assessments of the selected articles were performed using the Newcastle-Ottawa Scale. Review Manager 5.3, was used to synthesize various parameters associated with the impact of mouth breathing on facial skeletal development and malocclusion. RESULTS: Following full-text evaluations for eligibility, 7 studies (387 mouth-breathing subjects and 433 nasal-breathing controls) were included in the final quantitative synthesis; they were all high-quality. The included indicators were SNA (p>0.050), ANS-PNS (p>0.050), 1.NB (p>0.050), MP-H (p>0.050), FMA (p>0.050), SNB (MD: -1.99, P <0.0001), ANB (MD: 0.95, P = 0.0005), SN-OP (MD: 3.20, P < 0.0001), SNGoGn (MD: 4.34, P < 0.0001), 1-NA (MD: 0.72, P = 0.004), 1. NA (MD: 1.98, P = 0.020), 1-NB (MD: 1.06, P < 0.0001), SPAS (MD: -5.23, P < 0.0001), PAS (MD: -2.11, P < 0.0001), and C3-H (MD: -1.34, P < 0.0001). CONCLUSIONS: The results showed that mouth breathing can cause underdevelopment of the mandible. The mandible rotated backward and downward, and the occlusal plane was steep. However, there was little effect on the maxilla. In addition, mouth breathing presented a tendency of lip inclination of the upper and lower anterior teeth. Airway stenosis was common in mouth-breathing children. TRIAL REGISTRATION: [email protected]; registration number CRD42019129198 KEYWORDS: Mouth breathing; Facial skeletal development; Children; Systematic review, Meta-analysis.

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Microscrew Anchorage in Skeletal Anterior Open-bite Treatment

The Angle Orthodontist ◽

10.2319/010906-14r.1 ◽

2007 ◽

Vol 77 (1) ◽

pp. 47-56 ◽

Cited By ~ 84

Author(s):

Chunlei Xun ◽

Xianglong Zeng ◽

Xing Wang

Keyword(s):

Alveolar Bone ◽

Open Bite ◽

Anterior Open Bite ◽

Posterior Teeth ◽

Miniscrew Implants ◽

Mandibular Plane ◽

Lateral Cephalograms ◽

Patient Cooperation ◽

Skeletal Pattern ◽

Skeletal Open Bite

Abstract Objective: To evaluate the effectiveness of miniscrew anchorage for intrusion of the posterior dentoalveolar region to correct skeletal open bite. Materials and Methods: The study was comprised of 12 patients (aged 14.3 to 27.2 years; mean 18.7 years) with anterior open bites. All the patients presented a Class II skeletal pattern and excessive posterior growth. Self-drilling miniscrew implants were inserted into the posterior midpalatal area and the buccal alveolar bone between the lower molars. A transpalatal and a lingual arch were used to maintain the molars on each side in order to avoid overrotation during intrusion. A force of 150 g was applied to the microscrews on each side to intrude the posterior teeth. Lateral cephalograms of all 12 patients were taken preintrusion and immediately after completion of the intrusion. The cephalometric films were measured and compared. Results: The results showed that the anterior open bites in 12 patients were all corrected in a mean of 6.8 months. Overbite increased by a mean of 4.2 mm (P < .001), from −2.2 mm in preintrusion to 2.0 mm in postintrusion. The maxillary and mandibular first molars were intruded for an average of 1.8 mm (P < .001) and 1.2 mm (P < .001), respectively. The mandibular plane angle was reduced by 2.3° (P < .001), which led to a counterclockwise rotation of the mandible with a significant decrease in the anterior facial heights (mean of 1.8 mm; P < .001). Conclusion: Miniscrew anchorage has the advantages of being a simpler procedure, being minimally invasive, and requiring minimal patient cooperation.

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Perawatan Gigitan Terbuka Anteroposterior Tipe Skeletal dengan Teknik Straightwire

Majalah Kedokteran Gigi Indonesia ◽

10.22146/majkedgiind.8754 ◽

2014 ◽

Vol 21 (2) ◽

pp. 178

Author(s):

Vega Mandala ◽

Wayan Ardhana ◽

Christnawati Christnawati

Keyword(s):

Orthodontic Treatment ◽

Open Bite ◽

Treatment Result ◽

Anterior Open Bite ◽

Anterior Crowding ◽

Straight Wire ◽

Anterior Teeth ◽

Precise Diagnosis ◽

Mandibular Teeth ◽

Skeletal Open Bite

Gigitan terbuka merupakan maloklusi yang bercirikan tidak terdapatnya tutup menutup gigi rahang atas dan bawah, dapat terjadi pada regio anterior maupun posterior dan dapat melibatkan dental maupun skeletal. Maloklusi ini memerlukan ketelitian dalam penentuan diagnosis dan perawatan untuk mendapatkan hasil perawatan yang baik dan kestabilan jangka panjang. Tujuan penulisan studi kasus ini adalah untuk menginformasikan manajemen pasien dengan gigitan terbuka tipe skeletal. Pasien pria berumur 19 tahun datang ke Klinik Ortodonsia FKG UGM dengan keluhan utama gigi depan yang tidak rata dan tidak dapat digunakan untuk menggigit. Pemeriksaan klinis menunjukkan pasien memiliki kebiasaan menelan dengan menjulurkan lidah. Pemeriksaan model studi menunjukkan maloklusi Angle kelas I dengan gigitan terbuka anterior dari regio premolar kedua kanan ke kiri sebesar 10,7 mm disertai malposisi gigi individual dan pergeseran garis tengah rahang bawah ke kiri. Pemeriksaan sefalometri menunjukkan relasi skeletal kelas II dengan retrusif bimaksila, rotasi mandibula searah jarum jam dan gigitan terbuka skeletal. Pasien menolak tindakan bedah ortognatik sehingga dilakukan perawatan ortodontik kamuflase. Perawatan diawali dengan latihan miofungsional untuk melatih cara penelanan yang benar dilanjutkan dengan perawatan ortodontik teknik straightwire dengan pencabutan empat gigi molar pertama. Penutupan gigitan terbuka menggunakan elastic box anterior. Hasil evaluasi menunjukkanpengurangan besar gigitan terbuka dari 10,7 mm menjadi 1,25 mm. Kesimpulannya elastic box anterior dapat digunakan untuk mengoreksi gigitan terbuka yang etiologinya melibatkan intrusi gigi anterior. Skeletal Anteroposterior Open Bite Treatment with Straight Wire Technique. Open bite is a malocclusion with characteristic no overlapping between maxillar and mandibular teeth. This malocclusion may occur in anterior or posterior region and involved dental or skeletal. This malocclusion needed precise diagnosis and treatment to get a good treatment result and long term stability. The aim of this case report was to inform management of patient with skeletal open bite. A 19 years old male came to orthodontic clinic Faculty of Dentistry Gadjah Mada University with the chief complaint anterior crowding, and anterior teeth cannot be used to bite. Clinical finding showed patient had tongue thrusting habit. Study model analysis showed class I Angle malocclusion with 10.7 mm anterior open bite from right second premolar to left second premolar, with individual teeth malposition and mandibular midline shifting to the left. Cephalometric finding showed class II skeletal relationship with bimaxillar retrusive, clockwise mandibular rotation and skeletal open bite. This patient refused orthognatic surgery, so he received camouflage orthodontic treatment. This treatment was started with monofunctional exercise to correct the swallowing action then continued with straight wire orthodontic treatment with four first molar extractions. Anterior box elastic was used to close the bite. Evaluation result showed open bite was decreased from 10.7 mm to 1.25 mm. The conclusion was anterior box elastic could be used in open bite correction that involved anterior teeth intrusion as an etiology.

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Open bite case treated with Invisalign

Journal of Clinical Review & Case Reports ◽

10.33140/jcrc.05.01.02 ◽

2019 ◽

Vol 5 (1) ◽

Keyword(s):

Open Bite ◽

Treatment Modalities ◽

Anterior Open Bite ◽

Mandibular Growth ◽

Long Term Stability ◽

Anterior Teeth ◽

Nasopharyngeal Airway ◽

Acceptable Method ◽

Proper Diagnosis

Anterior open bite (AOB) is defined as the lack of incisal contact between anterior teeth in centric relation. Prevalence in the population ranges from 1.5% to 11.6%. The age factor, however, affects prevalence, since sucking habits decrease and oral function matures with age. At six years old 4.2% present with AOB whereas at age 14 the prevalence decreases to 2%. Anterior open bite is considered to be one of the most difficult treatments. Proper diagnosis and treatment planning, successful treatment, and retention have been stressed for the long-term stability of open bite treatment. There are several factors that could be related to the development of open bite. Among these are an unfavorable mandibular growth pattern, heredity, imbalances between jaw postures, digit-sucking habits, nasopharyngeal airway obstruction, tongue posture and activity and head position. Various treatment modalities have been proposed for the correction of anterior open bites: surgical and nonsurgical. In general, stability is the most important criteria in choosing an acceptable method of treatment for patients with open bite malocclusion. Many previous studies have indicated that if open bite correction is not stable, it is because the tongue continues to be postured anteriorly, which causes the bite to reopen. We will present an adult case treated with Invisalign. The treatment duration was 40 weeks and the anterior open bite was mainly corrected with relative extrusion of the incisors.

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Problems of dental preservation and complex therapy of chronic generalized periodontitis

Medical Journal of the Russian Federation ◽

10.17816/0869-2106-2021-27-1-71-78 ◽

2021 ◽

Vol 27 (1) ◽

pp. 71-78

Author(s):

Igor S. Kopetsky ◽

Lyudmila V. Pobozhieva ◽

Alyona I. Kopetskaya ◽

Juliya V. Shevelyuk

Keyword(s):

Bone Loss ◽

Service Life ◽

Tooth Loss ◽

Periodontal Diseases ◽

Epidemiological Studies ◽

Periodontal Pocket ◽

Treatment Result ◽

Entire Group ◽

Related Factors ◽

Anterior Teeth

Epidemiological studies have reported the prevalence of inflammatory periodontal diseases of 85%90% in individuals aged 30 years. Predicting the possibility of preserving teeth is an important integral part of treatment planning for periodontitis. Traditionally, the prognosis is based on the likelihood of tooth loss. The article presents a review of the literature characterizing the factors that affect the prognosis of the service life of teeth in case of periodontitis. For the literature review, a literature search was performed on the MedLine, EMBASE, CyberLeninka, and eLibrary databases. The following factors should be considered when assessing the long-term prognosis in patients with the highest risk for tooth loss: severity of periodontitis, smoking, bruxism, number of abutment teeth, age, type of tooth, depth of probing the periodontal pocket, bone loss, furcation involvement, root mobility and proportions, and tooth crowns. Indicators for molar loss include furcation lesion, bone loss progression, endodontic treatment, persistent periodontal pocket, age, female sex, smoking, and diabetes mellitus. A favorable treatment result and preservation of teeth depend on the entire group of teeth, with the following values: 85% in single-rooted anterior teeth, 78% in premolars, and 47% in molars. The low accuracy of standard predictive tooth loss indices can be explained by the point that the indices are mainly based on factors related to teeth and do not take into account the influence of patient-related factors. Thus, predicting the service life of teeth with periodontitis is a difficult task and requires taking into account both individual indicators of periodontal status and general factors.

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